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the measurement standards are wrong; for example we have recently learned that it can be harmful to over-correct blood pressure or blood sugar. Sometimes the protocol encourages adding yet another medicine, which may encourage too many medicines, which in turn can be harmful. Sometimes quality measures encourage excessive testing or more medicine instead of more comfort and pain relief when the patient is certainly dying. And to top it off, I suspect sometimes what is measured may depend on how much money the hospital is spending on measuring rather than on caring for patients.
• There are good things that have followed this trend, however. I have watched how old habits have changed to better ones, how nationally accepted important standards of care are becoming habits. The emphasis on safety is good, and I especially like what is being accomplished with "transitions of care," or how well we are making sure the patient has a medical home to go to after the hospital experience.
• Certainly quality of care is not the fanciness of a new building, richness of a lobby, or the expense of advertising. It has all to do with the quality of the people working within, the time they have to spend with you, how they transition your care to home, and the support the hospital gives to those people to do these important acts.
• Measuring quality is a challenging goal, and you can bet there will be a lot more kicking of tires to come.
• Dr. Rick Holm wrote this Prairie Doc Perspective for "On Call®," a weekly program where medical professionals discuss health concerns for the general public.  "On Call®" is produced by the Healing Words Foundation in association with the South Dakota State University Journalism Department. "On Call®" airs Thursdays on South Dakota Public Broadcasting-Television at 7 p.m. Central, 6 p.m. Mountain. Visit us at OnCallTelevision.com.